An airplane is drawn up into the sky. It is the shape of the wing, not the powerful engines that actually do the lifting. Without the specially shaped wings, an airplane would be just merely a fast bus.

It is the shape of your practice, that draws new patients and produces an uplift in your patient volume and practice income. Not self-effort, cleaver gimmicks or a shortage of new patient specials.

What shape is your practice in?

Do you have distinct edges (clear boundaries) defining what is your responsibility and what is the patients? Do you have the internal strength (staff training) to withstand the pressures of more new patients? Do you have a checklist (patient education system) to insure each patient attaches an appropriate meaning to what you’re doing? Do you have the momentum (driving purpose) to create the necessary lift?

Practice growth is more about a shortage of you, rather than a shortage of new patients!

It appears that economic forces are conspiring to root out those in the chiropractic profession who are irrelevant, inauthentic or just misguided. Naturally, this is painful for those whose dreams of helping people by delivering chiropractic care are being called into question. The open market can be a strict disciplinarian. For many who have practiced the majority of their careers under the “price supports” offered by insurance carriers, today’s realities can be a rude, if not harsh wake up call.

Price supports? Like the government that props-up the price of corn, wheat or soybeans, during the Insurance Era chiropractors benefited from insurance policies that paid inflated fees for services that few cash-paying (free market) patients could or would pay for. This prompted many chiropractors to toy with the notion of a dual (and illegal) fee system, charging patients with insurance policies a higher fee than those who didn’t have insurance or had exhausted their benefits.

This is a subplot of a far greater drama that plays out as some chiropractors go to extraordinary lengths in the pursuit of being “successful.”

Do you play full out?

Holding back, even a little, reveals a fundamental distrust of your circumstances, which actually permits your deepest fears to manifest.

Why do you distrust your circumstances? Could it be you see yourself as a victim? Or an unwilling partner in the creation of your life? Or you lack faith, having doubt about the future? When you “hedge your bet,” you're actually betting against yourself.

Not being fully invested in your own practice gives you a convenient “out” and an excuse for any shortcoming that arises. It’s a convenient face-saving strategy that actually sows the seeds for the very disappointment you fear.

Instead, this week, commit! Put on a pair of rose-colored glasses. Instead of the downside, concentrate on the upside. Assume everything is going to work out perfectly. Because it always does. It may not be what you expected, but remember, every effect has a cause.

Probably one of the most misleading movies used to inspire naïve chiropractors is the one with James Earl Jones and Kevin Costner who builds a baseball field in the middle of his Iowa cornfield.

“If you build it, they will come.”

The throaty whisper, combined with a healthy dose of 60s idealism makes for great drama as the Costner character gambles foreclosure on his farm in favor of following his passion for baseball.

It’s a movie! It’s made up. Yet, countless chiropractors emerge from chiropractic college with the notion that all it takes to heal the hurting humanity in their town is a highly-trafficked practice location, a backlit sign and a spanking new diploma framed on the wall.

Is this merely a hallucination perpetrated by chiropractic colleges interested in enrollees with good enough credit to swing student loans? I doubt it. I think there’s something more significant happening here.

Among all the possible problems in a chiropractic practice, patients are rarely the problem. Yet, in some practices, certain patients are the target of derision, judgment and even contempt, as in “problem patients.” Whether comments about their priorities, appearance or hygiene, these unservant-like attitudes are often the subject of staff meetings or post-visit hallway gossip.

Patients are hardly ever the problem. But your reaction can be.

If you speak ill of a patient it means you think ill of the patient. If you think ill of the patient, you can be sure that it’s obscuring the fullness of your healing intent. In other words, you’re shortchanging the patient. It becomes a form of stealing.

Think ill of no one. Speak ill of no one. Especially patients. Doing so is not only unbecoming, it actually serves to promote ill health -- the opposite of why patients seek you in the first place.

One of the greatest presents you can give patients is being fully 100% present.

The present is when your intention is the most powerful.

The present is when patients manifest in your practice.

The present is when you deliver your intervention.

The present is the only moment that is real--the past is merely a memory and the future resides in our imagination.

What diminishes your impact by distracting you from being present with patients? Eavesdropping in on a front desk conversation? Worrying about your bills? Computing your income from the day’s patient volume? Regrets about something you should have said or done?

Legendary healers are keenly aware of the importance of being present. More presence gives your listening and your adjusting more horsepower. It’s a self-discipline that the busiest practitioners consciously practice. It’s a characteristic that patients interpret as confidence, certainty and a loyality-producing hopefulness. It’s the technique of techniques.

There are many practitioners whose practices are growing; having their best year ever. That may be hard to believe if you find yourself in the pit and feeling stuck.

This was a topic that Dr. Sig Miller wanted me to address in a recent Webinar for the Association of New Jersey Chiropractors last week.

The 51-minute Webinar is free and you can watch it by clicking here. (You may need to download the most recent Flash plugin to avoid the show stalling along the way. Get the Windows version here.)

I won’t give away the punch line, but I think you’ll find it a helpful collection of practical things you can do, and a couple of more resourceful ways of being. By the way, extricating yourself from the predicament of decreased patient volume, reduced income or questioning your career path is actually more about being than doing. Frustrating I know, since most of us, when faced with a challenge, instinctively look for something we can “do” to “fix” the problem. Fixing is big with chiropractors—whether fixing spines or fixing their circumstances.

Hope you enjoy the suggestions. Hope you’ll act on them. Hope you’ll let me know.